Review article

https://doi.org/10.15836/ccar.2014.48

Inhibitors of ADP-dependent platelet aggregation.

Aleksandar Knežević ; Croatian Cardiac Society

Abstract

Platelets play a central role in the pathogenesis of atherothrombosis. Platelet adenosine diphosphate (ADP) receptors (P2Y12) have a key role in the aggregation potentiating the effect of many other factors involved in it. Inhibitors of ADP-dependent platelet aggregation (ticlopidine, clopidogrel, prasugrel, ticagrelor) are a group of drugs that increases antiaggregation effect, especially in the initial phase of platelet activation and thereby make a significant contribution to the treatment of atherothrombotic disease, especially ACS (acute coronary syndrome). Ticlopidine was the first that was introduced into clinical practice, but hematologic side-effects and the slow start of effects have quickly limited the clinical application. Clopidogrel with acetylsalicylic acid is fast becoming the gold standard in antiaggregation therapy after PCI (percutaneous coronary intervention) even in ACS. But its pharmacokinetic and pharmacodynamic limitations lead to the development of new drugs. Prasugrel has a more potent and faster antiaggregation effect, but at the expense of more extensive bleeding. Ticagrelor is the last from this group of drugs with the advantage of a potent, efficient, rapid and reversible P2Y12 receptor antagonist over clopidogrel. According to the applicable guidelines, it is a preferred drug for PCI in ACS and its status in the List of the Croatian Health Insurance Fund limits its wider use in Croatia at the moment.

Keywords

antiaggregation therapy; ticlopidine; clopidogrel; prasugrel; ticagrelor

Hrčak ID:

141153

URI

https://hrcak.srce.hr/141153

Publication date:

17.2.2014.

Article data in other languages: croatian

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